Communicating Hydrocephalus

A 56-year-old surgeon presented with memory deficits and dysphoric mood unresponsive to antidepressants. Her symptoms had necessitated early retirement. A 56-year-old woman, who was a pediatric surgeon, presented with a five-year history of memory deficits, loss of professional self-confidence, and dysphoric mood that was unresponsive to antidepressant medication; her symptoms had necessitated early retirement. Notable findings on the physical examination included a large head circumference (59 cm) and a bulging forehead. Neurologic examination showed bilateral palmomental reflexes but no other frontal reflexes. The patient was not incontinent and had a normal gait. T 1 -weighted magnetic resonance imaging (MRI) showed gross enlargement of the lateral, third, and fourth ventricles and effacement of the subarachnoid space (Panels A and B). . . .